Challenges of Obtaining Informed Consent in Emergency Ward: A Qualitative Study in One Iranian Hospital

Davoudi, Nayyereh; Nayeri, Nahid Dehghan; Zokaei, Mohammad Saeed; Fazeli, Nematallah

doi:10.2174/1874434601711010263

Cited by 11 publications

(7 citation statements)

References 30 publications

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“…Examples of factors include assisting a physician who believes the nurse is not suitably experienced or qualified to provide health care, taking therapeutic measures to delay patient death, conducting unnecessary treatments and tests, ignoring errors made by other health care providers, working with inexperienced health care providers, 38 and obtaining informed consent. 39 The recent study has indicated that environmental barriers to observing professional ethics in the emergency department are high, which is consistent with the results of the current study. 19 Currently, we are in the middle of the COVID-19 pandemic.…”

Section: Discussionsupporting

confidence: 92%

The barriers to observing professional ethics in the practice of nursing care from nurses’ viewpoints

et al. 2020

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Aims This study aimed to investigate barriers in the observation of professional ethics during clinical care from a nursing viewpoint. Also, it examined the association between these barriers and nurse demographic variables. Methods A descriptive-analytic design was carried out on 207 nurses working in selected hospitals within an urban area of Iran in 2019. Data were collected using a standard questionnaire containing 33 questions that measured barriers to observation of professional ethics. The questionnaire measures three domains of management, environment and individual care. Results In the management dimension, the most important barrier preventing observation of professional ethics was the shortage of personnel. For the environmental dimension, biological changes due to working on the nightshift, and for the individual care dimension, a lack of time were the most important barriers preventing observation of clinical ethics. Findings additionally highlighted a significantly inverse association between barriers to observing professional ethics and the male gender, participating in the ethics workshop and high work-level experiences. Conclusions It is suggested that nursing managers in hospitals correct and remove obstacles with careful planning and emphasis on principles and standards of care including environmental and managerial factors and training professional ethics to nurses.

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Section: Discussionsupporting

confidence: 92%

The barriers to observing professional ethics in the practice of nursing care from nurses’ viewpoints

et al. 2020

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“…Of the 18 articles that were reviewed, 5 studies were literature reviews and systematic reviews, 14 – 16 , 28 , 34 4 were cross-sectional studies, 22 , 25 , 31 , 32 2 were qualitative studies, 21 , 31 3 were ethical articles, 24 , 27 , 30 2 were cohort/case-control studies, 26 , 29 and 2 were review articles. 23 , 33 The themes explored in these studies were emergency consent, ethical and theoretical concepts of informed consent, stakeholders’ perceptions to informed consent, challenges of emergency surgery consent, and policies on emergency surgery consent.…”

Section: Resultsmentioning

confidence: 99%

Informed consent process for emergency surgery: A scoping review of stakeholders’ perspectives, challenges, ethical concepts, and policies

et al. 2023

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Background: A scoping review of literature about the informed consent process for emergency surgery from the perspectives of the patients, next of kin, emergency staff, and available guiding policies. Objectives: To provide an overview of the informed consent process for emergency surgery; the challenges that arise from the perspectives of the patients, emergency staff, and next of kin; policies that guide informed consent for emergency surgery; and to identify any knowledge gaps that could guide further inquiry in this area. Methods: We searched Google Scholar, PubMed/MEDLINE databases as well as Sheridan Libraries and Welch Medical Library from 1990 to 2021. We included journal articles published in English and excluded non-peer-reviewed journal articles, unpublished manuscripts, and conference abstracts. The themes explored were emergency surgery consent, ethical and theoretical concepts, stakeholders’ perceptions, challenges, and policies on emergency surgery. Articles were reviewed by three independent reviewers for relevance. Results: Of the 65 articles retrieved, 18 articles were included. Of the 18 articles reviewed, 5 addressed emergency informed consent, 9 stakeholders’ perspectives, 7 the challenges of emergency informed consent, 3 ethical and theoretical concepts of emergency informed consent, and 3 articles addressed policies of emergency surgery informed consent. Conclusion: There is poor satisfaction in the informed consent process in emergency surgery. Impaired capacity to consent and limited time are a challenge. Policies recommend that informed consent should not delay life-saving emergency care and patient’s best interests must be upheld.

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“…Some researchers have argued that paternalism is justified for illiterate people because they lack information and understanding and therefore are unable to make informed decisions [ 20 , 21 ]. Davoudi et al described medical paternalism as a cultural belief that the patients and their attendants do not have the required literacy to make decisions especially when they are anxious like in an emergency setting [ 22 ]. Other research has shown the paternalistic relationship patients have with their doctors especially in emergencies [ 13 ] which might be heightened in patients with a lower level of education.…”

Section: Discussionmentioning

confidence: 99%

Experiences of patients and next of kin on informed consent process for emergency surgery in two Urban university teaching hospitals in Uganda: a comparative cross sectional study

et al. 2023

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Informed consent for emergency surgery is a process in which a patient or their next of kin must make quick decisions required for surgery in a life-threatening situation or surgery that may have life-altering outcomes. The objective of the study was to describe patients and their next of kin experiences and factors influencing the informed consent process in two urban university teaching hospitals in Uganda. Methods: A cross-sectional survey involving patients who underwent emergency surgery and their next of kin was conducted in two tertiary care hospitals; one public and one private-not-for profit institution. A questionnaire was administered to collect sociodemographic information, type of Surgery that was done, how informed consent was obtained and experiences and expectations from the informed consent process. Univariate and multivariate analyses of the variables was done. Results: We collected data from 210 patients from a public hospital and 170 from a private-not-for profit hospital. Overall, most patients did not have the risks of the surgery communicated to them (79.7%), were not given alternative options (87.6%) and had no opportunity to ask questions (57.4%). Patients at the private institution had 3.35 times the odds of expecting the consent form to be explained to them than those at the public institution. Patients at the public hospital had 0.12 times the odds of preferring to have consent administered by a nurse than patients at the private institution OR 0.12 (0.05–0.29, p < 0.001). Patients in the public institution had 0.18 times the odds of preferring to have consent administered by a doctor than patients in the private institution OR 0.18 (0.08–0.45, p < 0.001). Conclusion: Patients in both public and private institutions are not informed about the risks of surgery, alternative options and are not given the opportunity to ask questions. Interpretation of the findings of this study on patient preferences on who administered consent though statistically significant were inconclusive due to the responses not being mutually exclusive.

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Challenges of Obtaining Informed Consent in Emergency Ward: A Qualitative Study in One Iranian Hospital

Cited by 11 publications

References 30 publications

The barriers to observing professional ethics in the practice of nursing care from nurses’ viewpoints

The barriers to observing professional ethics in the practice of nursing care from nurses’ viewpoints

Informed consent process for emergency surgery: A scoping review of stakeholders’ perspectives, challenges, ethical concepts, and policies

Experiences of patients and next of kin on informed consent process for emergency surgery in two Urban university teaching hospitals in Uganda: a comparative cross sectional study

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